%0 Journal Article %J Addict Behav %D 2016 %T Motives for marijuana use among heavy-using high school students: An analysis of structure and utility of the Comprehensive Marijuana Motives Questionnaire. %A Blevins, Claire E %A Banes, Kelsey E %A Stephens, Robert S %A Walker, Denise D %A Roffman, Roger A %X

Motives for marijuana use are important predictors of problematic outcomes associated with marijuana use. Most measures, to date, were developed by adapting alcohol motives measures. However, the Comprehensive Marijuana Motives Questionnaire (CMMQ) was created using a bottom-up approach to evaluate twelve distinct motives for use. The CMMQ was developed and validated in a normative college population. As such, no known study has evaluated the factor structure and utility of the CMMQ in a heavy-using, high school student population. The current study utilized a sample of 252 heavy marijuana-using high school students recruited for a combination motivational enhancement/cognitive behavioral intervention. Results from baseline measures indicated that the factor structure of the CMMQ was maintained in this population. Results from multiple regression analyses revealed distinct relationships with measures of negative consequences of use, including indices of marijuana use, marijuana-related problems, self-efficacy, and internalizing and externalizing symptoms. In particular, the Coping motive was associated with several negative outcomes, which is consistent with previous marijuana and alcohol motives literature. Results suggest that the CMMQ may be useful in assessing marijuana motives among heavy marijuana-using adolescents.

%B Addict Behav %V 57 %P 42-7 %8 2016 Jun %G eng %R 10.1016/j.addbeh.2016.02.005 %0 Journal Article %J Addict Behav %D 2016 %T A preliminary evaluation of synthetic cannabinoid use among adolescent cannabis users: Characteristics and treatment outcomes. %A Blevins, Claire E %A Banes, Kelsey E %A Stephens, Robert S %A Walker, Denise D %A Roffman, Roger A %X

Little is known regarding the use of synthetic cannabinoids (SC), particularly use among adolescent substance users who may be at higher risk. The present exploratory study seeks to describe SC use and subjective effects among cannabis-using adolescents as well as compare the characteristics of cannabis users who do and do not use SC. Exploratory analyses evaluated cannabis treatment outcomes among SC users and non-users. Participants enrolled in a randomized, controlled intervention for cannabis-using high school students aged 14-19 (N=252) completed questionnaires regarding their use of SC and other substances. Those who used SC in the past 60days reported subjective effects of SC, consequences, and SC use disorder symptoms. Baseline characteristics, alcohol and other drug use, and treatment outcomes of SC users were compared to participants who never tried SC. Within this sample 29% had tried SC, and 6% used SC recently. Although most reported use at a relatively low rate, 43% of recent SC users reported SC use-disorder symptoms. Positive and negative subjective effects of SC were endorsed, with positive subjective effects reported more often. SC use was associated with more cannabis use, but not more alcohol or other (non-SC and non-cannabis) drug use. SC users did not differ from non-users on cannabis treatment outcomes. This exploratory study described SC use, and compared characteristics and treatment outcomes among SC users and non-users. Negative subjective effects of SC were reported as occurring less often, but SC use was associated with use disorder psychopathology. SC use was associated with more problematic cannabis use at baseline, but was not associated with use of other substances or differences in treatment outcome.

%B Addict Behav %V 63 %P 114-9 %8 2016 Dec %G eng %R 10.1016/j.addbeh.2016.07.005 %0 Journal Article %J Addict Behav %D 2016 %T The relationship between general causality orientation and treatment outcome among marijuana-dependent adults. %A Blevins, Claire E %A Banes, Kelsey E %A Walker, Denise D %A Stephens, Robert S %A Roffman, Roger A %X

General causality orientations are motivational styles that are indicative of a person's belief about personal change and their motivation to change. The purpose of the current study was to investigate whether causality orientations were associated with marijuana treatment outcomes in a sample of marijuana-dependent individuals. A total of 74 participants (66% male) were recruited from the Seattle, Washington area and randomly assigned to receive a combination of motivational enhancement and cognitive behavioral therapy or the combination treatment plus additional "check-up" sessions. Follow-up assessments evaluated frequency of use, use-related problems, and marijuana use disorder symptoms through 9months. Causality orientations were relatively stable over time. Posttreatment Autonomy orientations were associated with lower frequency of use and Controlled orientations were associated with a reduction in use, problems, and marijuana use disorder symptoms. Autonomy and Controlled orientations were associated with readiness to change. Results suggest that both autonomous and controlled orientations have implications for response to treatment; perhaps for different reasons. Causality orientations may be a promising avenue of research to predict treatment response and outcome.

%B Addict Behav %V 53 %P 196-200 %8 2016 Feb %G eng %R 10.1016/j.addbeh.2015.10.021 %0 Journal Article %J J Subst Abuse Treat %D 2015 %T Maintenance Check-ups Following Treatment for Cannabis Dependence. %A Walker, Denise D %A Stephens, Robert S %A Towe, Sheri %A Banes, Kelsey %A Roffman, Roger %K Adult %K Cognitive Therapy %K Continuity of Patient Care %K Female %K Follow-Up Studies %K Humans %K Male %K Marijuana Abuse %K Middle Aged %K Motivational Interviewing %K Random Allocation %K Treatment Outcome %X

Substance use disorders, including cannabis use disorders and associated negative consequences, are best considered chronic and in need of continuing care. In contrast, most treatment efficacy studies evaluate a fixed number of intervention sessions at a single point in time. The present study evaluated the efficacy of posttreatment maintenance check-ups (MCUs) in maintaining and improving outcomes following nine sessions of motivational enhancement treatment/cognitive behavioral treatment (MET/CBT). Adults dependent on cannabis (n=74) were randomly assigned to the MCU or a no check-up (NCU) condition and followed up at 3- and 9-months. MCU sessions occurred 1 and 4months following the completion of the base treatment. Additional MET/CBT sessions were available to participants throughout the follow-up period. The MCUs specifically encouraged treatment re-entry for those showing ongoing signs of disorder. Participants in the MCU condition reported significantly greater abstinent rates at both follow-ups and were using on fewer days at the 3-month but not the 9-month follow-up. Contrary to hypotheses, MCU participants did not attend more additional treatment and differences in rates of cannabis use emerged prior to the first MCU session. Future research with longer follow-up periods and longer monitoring of outcomes is needed to fully evaluate the utility of MCUs or other forms of continuing care.

%B J Subst Abuse Treat %V 56 %P 11-5 %8 2015 Sep %G eng %R 10.1016/j.jsat.2015.03.006 %0 Journal Article %J Addict Behav %D 2014 %T Situational determinants of use and treatment outcomes in marijuana dependent adults. %A Blevins, Claire E %A Stephens, Robert S %A Walker, Denise D %A Roffman, Roger A %K Adaptation, Psychological %K Adult %K Cognitive Therapy %K Female %K Humans %K Male %K Marijuana Abuse %K Motivation %K Regression Analysis %K Risk Factors %K Self Efficacy %K Treatment Outcome %X

Research and theory strongly support the importance of situational determinants of substance use as targets for intervention, but few studies have systematically examined situational use characteristics in marijuana dependent adults. The present study describes situational use of marijuana in a population of 87 marijuana dependent adults and reports relationships with outcomes of treatment. Use in negative affective situations was independently associated with psychological distress, maladaptive coping strategies, lower self-efficacy, and poorer outcomes post-treatment. The findings were consistent with research on using drugs to cope with negative affect providing evidence of convergence between two different methods of assessing high risk situations for substance use. The results support continued emphasis on coping with negative affect as a target in treatments for marijuana dependence.

%B Addict Behav %V 39 %P 546-52 %8 2014 Mar %G eng %N 3 %R 10.1016/j.addbeh.2013.10.031 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Motives for cannabis use in high-risk adolescent users. %A Fox, Courtney L %A Towe, Sheri L %A Stephens, Robert S %A Walker, Denise D %A Roffman, Roger A %K Adaptation, Psychological %K Adolescent %K Female %K Humans %K Male %K Marijuana Abuse %K Marijuana Smoking %K Motivation %K Risk Factors %X

The present investigation examined the relationships between motives for cannabis use and negative consequences associated with cannabis use following a brief intervention. The sample consisted of 205 adolescent cannabis users (66.3% male), who were recruited in high schools and randomly assigned to a brief two-session motivational enhancement therapy (MET) or an educational feedback control (EFC). Results supported the hypothesis that using cannabis to cope with negative affect would predict the number of problems and dependence symptoms related to cannabis use, after controlling for age, gender, years and frequency of cannabis use, and internalizing and externalizing behavior problems. Significant interactions between internalizing behavior problems and the coping motive showed that using to cope was associated with a higher number of cannabis dependence symptoms among adolescents reporting lower levels internalizing behavior problems. Findings support the potential utility of conducting further research to explore the coping motive as an important indicator of problematic cannabis use.

%B Psychol Addict Behav %V 25 %P 492-500 %8 2011 Sep %G eng %N 3 %R 10.1037/a0024331 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Social norms and self-efficacy among heavy using adolescent marijuana smokers. %A Walker, Denise D %A Neighbors, Clayton %A Rodriguez, Lindsey M %A Stephens, Robert S %A Roffman, Roger A %K Adolescent %K Adolescent Behavior %K Cross-Sectional Studies %K Diagnostic and Statistical Manual of Mental Disorders %K Female %K Health Behavior %K Humans %K Male %K Marijuana Abuse %K Marijuana Smoking %K Models, Psychological %K Peer Group %K Randomized Controlled Trials as Topic %K Self Efficacy %K Self Report %K Social Conformity %K Social Facilitation %K Young Adult %X

Adolescence is a time in which individuals are particularly likely to engage in health-risk behaviors, with marijuana being the most prevalent illicit drug used. Perceptions of others' use (i.e., norms) have previously been found to be related to increased marijuana use. Additionally, low refusal self-efficacy has been associated with increased marijuana consumption. This cross-sectional study examined the effects of normative perceptions and self-efficacy on negative marijuana outcomes for a heavy using adolescent population. A structural equation model was tested and supported such that significant indirect paths were present from descriptive norms to marijuana outcomes through self-efficacy. Implications for prevention and intervention with heavy using adolescent marijuana users are discussed.

%B Psychol Addict Behav %V 25 %P 727-32 %8 2011 Dec %G eng %N 4 %R 10.1037/a0024958